Hospital Abuja Research Articles

Chlorhexidine Wound Irrigation for the Prevention of Early Surgical Site Infection in Orthopaedic Surgeries in Resource-Limited Settings: A Randomized Controlled Trial.

Background and objectives Surgical site infections (SSIs) in orthopaedic surgeries continue to pose significant challenges, leading to increased morbidity and strain on healthcare resources especially in resource-limited countries. Intra-operative wound irrigation is a common practice globally, although evidence supporting this practice is lacking. We aimed to determine the preventative effective of chlorhexidine gluconate (CHG) for prevention of early SSIs in orthopaedic surgeries. Methods This is a prospective randomized controlled interventional clinical trial which was designed at National Hospital Abuja, Abuja, Nigeria. A total of 50 patients were enrolled and randomized into two groups: one receiving 0.05% CHG solution and the other receiving isotonic 0.9% saline for wound irrigation. The incidence of early SSIs (within 30 days) postoperatively was the primary outcome measured. Patients and outcome assessors were blinded to intervention allocation. Results The results showed no significant difference in the clinical profile of the patients in both groups. There was a similar rate of early SSIs between the CHG (4%) and isotonic saline (4%) groups. Conclusions There is no significant difference between CHG and isotonic 0.9% saline in preventing early SSIs in clean orthopaedic implant surgeries. These data will improve care and allow appropriate allocation of scarce resources in resource-limited settings.

The Impact of Antiretroviral Therapy on Birth Outcomes: A Retrospective Cohort Study

Objective: This study aimed to evaluate the impact of highly active antiretroviral therapy (HAART) on pregnancy outcomes at a major tertiary hospital in Abuja, Nigeria. Design: A cohort study was conducted. Methods: HIV-infected pregnant women who initiated HAART during pregnancy for the prevention of mother-to-child transmission (pMTCT) were recruited, alongside a randomly selected group of HIV-uninfected pregnant women. Results: A total of 489 pregnant women participated, including 237 HIV-infected and 252 HIV-uninfected women. HAART initiation during pregnancy was significantly associated with higher mean birth weights (p = 0.0007). While there were 30 cases of low birth weight in the HIV-infected group compared to 21 in the HIV-uninfected group, HAART was not significantly associated with low birth weight (OR 1.59, p = 0.1182). There were 6 stillbirths in the HIV-infected group and 5 in the uninfected group, with no significant association between HIV status and stillbirth (OR 1.28, p = 0.6836). However, 29 preterm deliveries occurred in the HIV-infected group compared to 8 in the uninfected group, showing a strong association between HIV infection and preterm deliveries despite HAART initiation (OR 4.25, p = 0.0002). Conclusion: HIV-infected women receiving HAART during pregnancy have a significantly reduced risk of low birth weight but face an increased risk of preterm delivery.

Early Operative Risk Assessment Using the Modified Mannheim Peritonitis Index in Patients With Generalised Peritonitis at a Tertiary Hospital in Abuja, Nigeria.

Introduction The use of validated prognostic scoring tools in resource-poor environments has been hampered by the cost of procuring and maintaining devices, such as arterial blood gas analysers, to measure critical physiological derangements.Attempts need to be made to adapt these applicable risk stratification tools so they can be easily adopted in developing countries like Nigeria. Aim This study assessed the usefulness of a modified Mannheim peritonitis index (mMPI) as arisk stratification tool in predicting surgical outcomes in managing patients with generalised peritonitis in Abuja, Nigeria. Methods This was a prospective study of consecutive adult patients managed for generalised peritonitis at a tertiary hospital in Abuja over 12 months. Approval numbers NHA/EC/037/2019 and AF/013/17/110/1514 were ascribed to the project by the Institute Review Board Committee (IBR) of the National Hospital Abuja (NHA) and the National Postgraduate Medical College of Nigeria. The MPI was modified using respiratory rate and suboptimal percentage oxygen saturation (SpO2). Patient characteristics and treatment outcomes obtained were entered into a structured proforma, checked, and analysed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States). The threshold score of the modified MPI and the accuracy, sensitivity, and specificity were derived from the receiver operating characteristic (ROC) curve analysis and its coordinates. The level of statistical significance was set at a p-value of <0.05. Results There were 49 patients with generalised peritonitis during the study period with a male-to-female ratio of 2.5:1. The commonest cause of peritonitis in this study was penetrating abdominal injury (n=15, 30.6%), followed by complicated appendicitis (n=12, 24.5%). This study's mortality and morbidity rates were 14.3% and 63.3%, respectively. On the ROC curve, the modified MPI best predicts mortality at a threshold score point of ≥26 (accuracy of 79.4%, sensitivity of 85.7%, specificity of 61.9%, p=0.013) and morbidity at a threshold score of ≥23 (accuracy of 78.4%, sensitivity of 77.4%, specificity of 72.2%, p=0.001). Conclusion The modified MPI can be used as a risk assessment tool to predict postoperative outcomes in adult patients operated on for generalised peritonitis within 30 days of operative intervention at Abuja.This modification may be helpful in low-resource centres with limited access to arterial blood gas analysers. However, the original MPI might be a more accurate tool.

FP7.18 - Early Operative Risk Assessment Using Modified Mannheim Peritonitis Index in Patients with Generalised Peritonitis at a Tertiary Hospital in Abuja, Nigeria

Abstract Aim This study assessed the usefulness of a modified Mannheim Peritonitis Index (MPI) as a risk stratification tool in predicting surgical outcomes in the management of patients with generalized peritonitis in Abuja, Nigeria. Methods This is a prospective study of consecutive adult patients managed for generalized peritonitis at a tertiary hospital in Abuja Nigeria within a one-year duration. The MPI was modified using respiratory rate and SpO2. Patient characteristics and outcome of treatment obtained were entered into a structured proforma, checked and analysed using the SPSS, version 25. The threshold score of the modified MPI, as well as the accuracy, sensitivity, and specificity, were derived from the receiver-operator characteristic (ROC) curve analysis and its coordinates. Results There were 49 patients with generalised peritonitis during the study period with a male-to-female ratio of 2.5:1. The commonest cause of peritonitis in this study was penetrating abdominal injury (30.6%) followed by complicated appendicitis (24.5%). This study's mortality and morbidity rates were 14.3% and 63.3%, respectively. On the ROC curve, the modified MPI best predict mortality at a threshold score point of ≥26 (Accuracy of 79.4%, sensitivity of 85.7% specificity of 61.9%, P-value = 0.013), and morbidity at a threshold score of ≥23 (Accuracy 78.4%, sensitivity of 77.4%, specificity of 72.2%, P-value = 0.001). Conclusion The modified MPI can be used as a risk assessment tool in predicting postoperative outcomes in adult patients operated for generalised peritonitis within 30 days of operative intervention at Abuja. This modification can be useful in low-resource centres with limited access to arterial blood gas analysers.

Cervical cancer screening practices of antenatal clinic attendees in Garki Hospital Abuja, Nigeria

Cervical cancer screening practices of antenatal clinic attendees in Garki Hospital Abuja, Nigeria

Molecular Characterization of Hepatitis B Virus among HIV Positive and HIV Negative Pregnant Antenatal Women in Federal Capital Territory Abuja Hospital

A significant contributor to chronic hepatitis, cirrhosis and hepatocellular carcinoma is the Hepatitis B Virus (HBV). Hepatitis B Virus (HBV) is a major cause of Chronic Hepatitis, cirrhosis and Hepatocellular Cancer (HCC). The incidence of HBV-related HCC cases is projected to increase for at least two decades due to the high prevalence of chronic HBV infection throughout the world. The overall aim of this study is to determine the sero-prevalence and molecular characterization of hepatitis B virus among HIV positive and HIV negative antenatal women attending Federal Capital Territory Abuja hospitals. A total number of 302 samples were collected from 302 participants between the ages of 18-55 years. The samples were screened for HIV, HBV, HBV serology markers, using rapid test kits, HBV Viral load and HBV genotyping was carried out using multiplex PCR method and data was analyzed using appropriate tools. Nine tested positive for HIV, 34 tested positive for HBV and 2 tested positive for both HIV and HBV, corresponding to 2.9 % (95% CI; 1.2 – 3.8) prevalence for HIV, 11.3% (95% CI; 8.7 – 13.6) for Hepatitis B and 0.7% for HIV/HBV co-infection. Age 25-35 years old had the highest prevalence of HBV 22(7.3%) followed by those of less than 25 years old 8(2.8%) and 1(0.7%) each for age range 36-45 years, 2(0.7%) and 46-55 years. HBeAb and HBcAb were expressed highest among subject within the age range of 25 – 35 year 14 (41.2%) and 22 (64.7 %,) participants respectively, followed by the age range of less than 25 years 5 (14.7%) and 8 (36.4%), for HBeAb and HBcAb respectively. There was no Hepatitis B envelop antigen (HBeAg) nor Hepatitis B surface antibody (HBsAb) among the study group. Of the 34 samples, 20 (62%) had undetectable viral load, while 14 (38%) had detectable viral load. Genotype E was three times more prevalent among those of 25 years old and above than those less than 25 years old detected (75% and 25%). However, genotype B/E mixed was more expressed (60% of cases) among those less than 25 years old, than those greater than 25 years of age (40%). There was no significant difference in the prevalence of genotype E and B/E serotype between HBV+/HIV-patients and their HBV+/HIV+ counterpart (P=0.08 and P=0.15, respectively). HBV Genotype E single infection viral load was significantly (P=0.01) more expressed among those 25 years of age and above than less than 25 years old (4,354,703 ± 346865 IU/ml versus 55.6 ±28.1 IU/ml). Mixed infection genotype B/E was significantly (P=0.04) more expressed among those less than 25 years of age than those 25 years old and above (730.9 ± 238 IU/ml versus IU/ml versus 91.1 ± 48 IU/ml). There was no significant difference between the mean of HBV Viral load HBV+/HIV- patients and their HBV+/HIV+ counterpart (T-test =0.009; P=0.92). In conclusion FCT is 11.3% prevalence rate of HBV and genotypes E and B/E are in circulation among pregnant women among the pregnant women attending antenatal clinic in FCT hospital in Abuja.

Knowledge, perception, attitude, and practice of complementary and alternative medicine by health care workers in Garki hospital Abuja, Nigeria

BackgroundHealthcare workers are currently making efforts to offer services that cater to the holistic care needs of their patients. Previous studies have shown that some healthcare workers encounter challenges when advising patients about Complementary and Alternative Medicine (CAM), even though its use is widespread. Many health care workers may not have received formal education or training in CAM and consequently are unable to address their patients’ questions about it. This study explored the knowledge, perception, attitude and practice of CAM by healthcare workers in Garki Hospital, Abuja, Nigeria.MethodsThis was an institution-based cross-sectional study, design and a convergent parallel, mixed methods design was used for data collection. Five (5) healthcare workers were purposively selected as participants for the key informant interviews, while two hundred and fifty (250) selected using a simple random sampling method completed the questionnaire. The data collection instruments used were a key informant interview guide and a 35-item self-administered questionnaire. Knowledge was assessed with a 4-item scale with a maximum score of 8. Perceptions and attitudes were assessed using Likert scales with a maximum score of 45 and 20, respectively. Practice was assessed with a 6-item scale with a maximum score of 18. Qualitative data was analysed using framework analysis. Quantitative data was analysed using descriptive and inferential statistics. Data acquired from both methods were integrated to form the findings.ResultsThe average age of respondents for the quantitative study was 34.0 ± 7.8 years, and they were predominantly females (61.2%) with one to ten years of work experience (68.8%). The mean knowledge, perception and attitude scores were 1.94 ± 1.39, 13.08 ± 2.34 and 32.68 ± 6.28, respectively. Multiple linear regression result showed that knowledge (t = 2.025, p = 0.044) and attitude (t = 5.961, p = 0.000) had statistically significant effects on the practice of CAM. Qualitative data revealed that the majority of the participants perceive CAM favourably, provided it is properly introduced into mainstream medicine with evidence of safety and research to prove its efficacy.ConclusionThe study has shown the gaps in knowledge and the practices of CAM by conventional medical practitioners. This has implications for their ability to counsel and refer patients who may require CAM therapies. Policy, research and programmatic initiatives that seek to enhance their knowledge of CAM, and improve collaboration with CAM practitioners are recommended.

Using Principal Component Analysis and Logistics Regression to Model Major Types of Cancer among Youth

Cancer poses a significant health challenge among young Nigerians due to high incidence rates and limited research on risk factors and outcomes. This study examines the utility of logistic regression and principal component analysis (PCA) in understanding cancer patterns, identifying risk factors, and predicting outcomes among Nigerian youth. Logistic regression assesses various factors such as genetics, environment, and lifestyle to predict cancer occurrence, enabling early detection and tailored interventions. PCA aids in uncovering complex data patterns by reducing dimensionality while preserving data variability. Nigeria experiences over 100,000 new cancer cases annually and a rising burden, effective statistical modelling is vital for guiding prevention and intervention strategies. The study compares different cancer types, develops risk assessment models, and forecasts cancer probabilities using logistic regression and PCA. These methodologies hold promise in enhancing cancer comprehension, diagnosis, and management among youth. Patient cancer data from the National Hospital in Abuja and the Aminu Kano Teaching Hospital in Kano were utilized, and selected through convenient sampling for accessibility and convenience. Direct observation served as the primary data collection method. This research underscores the importance of employing statistical modelling techniques, particularly logistic regression and PCA, to address the multifaceted challenges of cancer among youth. Leveraging analytical frameworks can advance early detection initiatives, tailored prevention strategies, and timely interventions, aligned with the region's unique socio-economic and cultural dynamics. Recommendations include prioritizing model validation, fostering collaborative efforts, increasing investment in cancer research infrastructure, and leveraging statistical modelling techniques to enhance cancer epidemiology understanding and healthcare outcomes among youth.

Predictive Role of Acute Physiology and Chronic Health Evaluation II (APACHE II) in Patients With Peritonitis at the National Hospital Abuja.

A validated tool may facilitate assessing the severity of peritonitis among surgical patients. This study evaluates the predictive role of Acute Physiology and Chronic Health Evaluation II (APACHE II) in the surgical outcomes of patients managed for peritonitis in Abuja. This is a prospective study of consecutive adult patients managed for peritonitis by the general surgery unit of National Hospital Abuja (NHA) over a 19-month period (September 2020 through March 2022). Patient characteristics and treatment outcomes were recorded in a structured proforma and analyzed using SPSS Statistics version 25 (IBM Corp., Released 2017; IBM SPSS Statistics for Windows, Version 25.0; Armonk, NY: IBM Corp.). The accuracy, sensitivity, specificity, and threshold of APACHE II were derived from the receiver operating characteristic (ROC) curve analysis and its coordinates. There were 54 patients with peritonitis during the study period, with a male-to-female ratio of 2.6:1. This study's mortality and morbidity rates were 13.0% and 63.0%, respectively. The APACHE II score at admission was positively correlated with the likelihood of postoperative mortality, morbidity, number of postoperative complications, ICU admission, and length of hospital admission. The average APACHE II score of patients in this study was 7.1±5.2. APACHE II best-predicted mortality by the ROC curve at a threshold point of 9 (sensitivity of 85.7%, specificity of 70.2%, the accuracy of 86.8%, P-value 0.002). At a threshold score of 6, APACHE II was significantly associated with the occurrence of postoperative morbidity (sensitivity of 74.3%, specificity of 73.7%, accuracy of 75.2%, P-value = 0.043). This study confirms that the APACHE II score at admission can predict the outcome of surgery within the first 30 days post-surgery among adult patients who had peritonitis at NHA.

Infant feeding practices among mothers of children between 6-24 months attending immunization clinical at National Hospital Abuja

No Abstract

The Child with a Large Head: Cranial Computed Tomography Findings in 123 Nigerian Children with Macrocephaly

Objectives: Differentiation of benign macrocephaly from other etiologies that may require prompt evaluation and intervention is very necessary to prevent long term neurological deficits. Cross-sectional imaging of the brain with Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) is recommended in evaluation of such patients. In resource poor-settings, CT is more readily available, hence the objective in this study is to evaluate the spectrum of CT findings in children with macrocephaly in our locality and document the possible etiologic factors that are amenable to surgical intervention.&#x0D; Materials and Methods: This is a retrospective study of pediatric patients with clinical diagnosis of large head/macrocephaly who were evaluated with cranial CT in a tertiary hospital in Abuja from January 2018- June 2022. SAS software (SAS Institute, Cary, North Carolina, USA) version 9.4 was used for database management and analysis with P≤ 0.05 level of significance.&#x0D; Results: One hundred and twenty three children were included in the study with ages ranging from 2 days to 4 years. Majority of the children were males, 74 (60.2%). The predominant age group at presentation was between 0 to 6 months,78 (63.4%). Hydrocephalus was the main cause of macrocephaly in 110 patients (89.4%). Congenital hydrocephalus was predominant in 81 children (73.6%). Communicating hydrocephalus was noted in 44 children (40%) while 62 (56.4%) were non-communicating. The commonest level of obstruction was at the aqueduct of Sylvius and exit foramina in 22 (35.5%) patients each. There was no significant statistical difference between the genders(P=0.920).&#x0D; Conclusion: CT is a veritable tool in the evaluation of the child with a large head with an appreciable number of surgically amenable pathologies noted. Hydrocephalus is the commonest etiology of macrocephaly in our environment with the majority of the cases due to congenital abnormalities.

Bacteriology of Urinary Tract Infection in Children Attending Federal Staff Hospital in Abuja

Urinary tract infection (UTI) is a term applied to a variety of clinical conditions ranging from asymptomatic presence of bacteria in the urine to severe infection of the kidney with resultant sepsis. The study was designed to identify the bacteria associated with urinary tract infection among children attending Federal staff hospital, Abuja and to ascertain their antibiogram. Mid-stream urine samples were collected from the subjects enrolled into the study and were cultured into Cysteine Lactose electrolyte deficient medium and Blood agar and incubated appropriately. The plates were read and isolated were subjected to biochemical reactions and antibiogram were carried out on pathogenic organisms. The results showed the overall prevalence of 10.8% urinary tract infections among the studied subjects. The females subject had the highest prevalence of 91.7% while the male counterpart recorded 8.3%. The age groups 1-5 years had the highest prevalence of 50.0% while least prevalent of 16.7% were recorded by age group 6 to 10 years old. Escherichia coli was the highest isolated with 51.7% while Proteus Species and Streptococcus faecalis recorded the prevalence of 2.5% respectively. This study concluded that urinary tract infections is very common among children attending Federal staff hospital in Abuja. Keywords: BA- Blood agar, CLED-Cysteine Lactose, Electrolyte deficient medium, FSH-Federal Staff Hospital, UTI- Urinary Tract Infection.

Analysis of diagnoses of chest injuries in a Nigerian trauma center.

Chest injury is one of the most common types of trauma-related injuries accounting for about 10% of trauma admissions in emergency services. The injuries may be immediate, life-threatening, or potentially life-threatening based on diagnosis after initial assessment. This study is intended to analyze the pattern of diagnosis found in chest-injured patients in a trauma center of a developing country. This is a retrospective study carried out in the trauma center of the National Hospital Abuja, Nigeria, between January 2015 and December 2017, as an analysis of the existing trauma registry. Data procession was done using SPSS version 24.0. Results were presented in tables and figures. A total of 637 patients' data was studied, male to female ratio of 3.58 and mean age of 34.18 ± 11.34 years. More patients sustained isolated chest injury (59.5%) and blunt chest injury (78%). The most frequent diagnosis was chest wall soft tissue injury (CWSTI) (46.6%) despite the exclusion of minor chest wall injuries who did not require any form of observation. Haemothorax and rib fractures were the next most common diagnoses after CWSTI constituting 13.5% and 8.7%, respectively, while flail chest and aortic injuries were the least comprising 0.6% and 0.2%, respectively. The commonest associated injuries were traumatic brain injury (11.3%), extremity fractures (11.1%), and abdominal injuries (7.8%). Penetrating injuries were more significantly associated with male gender and isolated chest injuries (P < 0.001). Chest wall soft tissue injuries constitute a large proportion of chest injuries seen in our setting. Despite its relatively low importance in the medical literature, it should be given attention in resource-poor settings in order to minimize missed significant injuries in the absence of diagnostic facilities. Therefore, high index of suspicion and low threshold for observation should be practiced in this group of patients.

Determination of Prostate Specific Antigen Level among Male Patients with Bacterial Urinary Tract Infections Attending Kuje General Hospital Abuja, Nigeria

Recent hospital and cancer registry data shows increasing prostate cancer incidence in Nigeria, which was previously regarded as a low incidence region. Prostate cancer is the leading cause of cancer death among men in Nigeria and second most common cancers of men worldwide and sexual history has been a consistent risk factor. Prostate specific antigen (PSA) test is still the single most important test for early detection of prostate cancer worldwide. However, not much is reported about prostate cancer in relation to urinary tract infections in Africa. This study investigates the prevalence of prostate cancer risk in and bacterial urinary tract infections among men in Abuja, Nigeria. One Hundred (100) samples each of blood and urine were collected, from fifty (50) male patients suffering from urinary tract infections and fifty (50) apparently healthy males attending Kuje General Hospital Abuja, Nigeria. All the blood samples were subjected to PSA analysis using Enzyme-linked Immunosorbent Assay procedure (Diagnostic Automation/ Cortez Diagnostics, Inc, USA) while urine analysis (microscopy, culture and biochemical identification) was performed on the urine to isolate and identify the common bacteria associated with urinary tract infections among the study population.

Plasmid Profile of Environmental and Clinical Isolates of Multidrug Resistant Salmonella Typhimurium from Patients Attending General Hospital Asokoro, Abuja and Environ

Plasmid is isolated from Salmonella typhimurium, an enteric bacterium responsible for gastro enteritis. Gastro enteritis remains a major clinical and public health problem all over the world, especially among children in the developing countries of the sub – Sahara Africa. The profiling of plasmid isolate of Salmonella typhimurium involved cultivation, isolation, identification, and characterization. The study aimed at investigating the multidrug resistance of salmonella typhimurium of patients attending General Hospital Asokoro with typhoid fever and the susceptibility of isolates to antibiotics. A total of thirty (30) samples, from blood, stool, and water were collected from patients attending General hospital, Asokoro and the environs. The specimens were analyzed using standard microbiological, biochemical, and serological techniques. Bacteriological analysis revealed that twenty-five (25) of the specimens were positive for Salmonella typhimurium. The other five (5) specimens were negative for salmonella typhymurium typhimurium. The biochemical test revealed that they were able to utilize sugar and are lactose fermenter. Anti-microbial susceptibility determination revealed that the most active drugs against salmonella include Ciprofloxacin, Ofloxacin, Amikacin, and Gentamicin. All the isolates were resistant to tetracycline and Ampicillin. There was marked resistance of all isolates to amoxicillin, doxycycline, and chloramphenicol. The result of findings revealed that the genes that encode resistance properties in Salmonella typhimurium are plasmid- borne in some of the bacteria. These plasmids can be cloned and used for genetic engineering and recombinant DNA technology. The antibiotic susceptibility determined the appropriate drugs efficient for therapy of Salmonella infections. Keywords: Antibiotic Susceptibility, Drug Resistance, Salmonella typhimurium, Plasmid.

Geospatial analysis of mortality risk from road traffic crashes in Federal Capital Territory, Nigeria

The objective of the study was to present a novel analytical approach using Nigerian trauma registry data to determine risks and of road traffic crash-related mortality for patients treated at National Trauma Centre, Abuja. Patient characteristics were compared between those who died at the hospital (n = 118) and those who survived (n = 2018). Multiple logistic regression and cluster analyses were used to identify risks of mortality and of high mortality and injury rates. The patient’s status as pedestrian (p &lt; .0001), and whether the crash occurred on an expressway or transition zone between expressways and local roads (p = 0.0045) were significantly associated with mortality. Cluster analysis further isolated significant of mortality rate (Moran’s I = 0.31), pedestrian injury rate (Moran’s I = 0.34), and expressway/transition zone injury rate (Moran’s I = 0.18). For patients who survived to hospitalization at National Hospital Abuja, pedestrians involved in a crash and those whose crashes occurred on expressways/transition zones were at higher risk of mortality. High mortality and pedestrian and expressway/transition zone injury rates isolated to five contiguous administrative wards in Abuja. These analysis methods can be applied to determine risks and hotspots of crashes, injuries, and mortality in various settings.

The Trend of Cholecystectomies After the Introduction of Laparoscopic Surgery in a District Hospital in Abuja, North Central Nigeria.

Background Laparoscopic cholecystectomy is not readily available in secondary care hospitals in Nigeria, even though it is now the gold standard for the treatment of cholelithiasis and other gallbladder diseases worldwide. Thus, many hospitals in Nigeria still offer open cholecystectomies. This retrospective study investigated the trend of cholecystectomies performed in the general surgery unit of a district hospital in Abuja before and after the commencement of laparoscopic surgery services in 2016. Methodology This retrospective study was conducted in Asokoro District Hospital, Abuja, Nigeria The records of all patients who underwent a cholecystectomy from January 2000 to December 2019 were retrieved and analyzed for the number, types, and rate of cholecystectomies performed per year. All open cholecystectomies were performed via a right subcostal incision, whereas all laparoscopic cholecystectomies were performed via the standard four-port incisions approach. Results A total of 96 patients underwent cholecystectomies from January 2000 to December 2019. In total, 50 (52.08%) open cholecystectomies were performed in 20 years with a yearly average of 2.5, and 46 (47.92%) laparoscopic cholecystectomies were performed in four years with a yearly average of 11.5. The trend of open cholecystectomies in four years dropped from three (30%) in 2016 to one (5.26%) in 2019, whereas laparoscopic cholecystectomies increased from seven (70%)to 18 (94.74%) within the same period. Conclusions There is a drop in the trend of open cholecystectomies and an increase in both laparoscopic and total cholecystectomies in our hospital. We recommend adequate capacity and subsidized laparoscopic cholecystectomy for secondary healthcare facilities in Nigeria.

Threshold and Correlation of Total Serum Bilirubin with Screening Automated Auditory Brainstem Response Among Newborns with Hyperbilirubinemia in National Hospital Abuja

Objective To determine the total serum bilirubin (TSB) cut-off value predictive of hearing impairment among newborns with hyperbilirubinemia at the National Hospital Abuja. Setting This was a cross-sectional study conducted in the Special Care Baby Unit (SCBU) and Neonatal Intensive Care Unit (NICU) of National Hospital Abuja between August 2020 and February 2021. Methods A universal sampling of eligible participants was done, and consent was obtained from the parent. Using the TSB and results of hearing screening carried out with the Otoport advance from Otodynamics®, the proportion of automated auditory brainstem response (AABR) screening failure was determined, and the receiver’s operating characteristics (ROC) curve coordinates were used to find the threshold bilirubin level for the risk of hearing loss. The Spearman-Rho correlation assessed the relationship between TSB level and AABR findings. Results 160 newborns below 28 days of age, delivered at 34 weeks gestation and above, who had clinical jaundice were recruited. The prevalence of screening AABR failure in at least one ear was 26.2%. The correlation between TSB and AABR was weakly positive (rs = .189, p = .093) and the TSB cut-off for AABR failure was 16.3 mg/dl (sensitivity 45.5%, specificity 81%, Youden’s-J statistic = 0.265). Conclusion The TSB threshold for AABR screening failure was 16.3 mg/dl, but TSB did not correlate well with screening AABR. Serum bilirubin above 15 mg/dl in late preterm and term neonates should be actively treated with phototherapy and/or exchange blood transfusions where feasible, particularly in resource-poor settings.

Assessment of Knowledge and Prevalence of antimicrobial use (AMU) among patients in a District Hospital in Abuja, Federal Capital Territory, Nigeria

Background: Worldwide, antimicrobial use is a major contributor to the development of antimicrobial resistance (AMR), with people and animals serving as the primary drivers. Knowledge of antibiotic rational use includes not only providers' actions in ensuring patients receive appropriate treatment for their condition, at the right dose and duration, but also patients' actions in adhering to the treatment protocols recommended, completing the full course, and not sharing or storing medicines for future use. This study aims to determine the knowledge and prevalence of antimicrobial use among patients in a District Hospital in Abuja, Federal Capital Territory, Nigeria. Methods: This was descriptive, cross-sectional study done in September, 2022 among 400 patients attending outpatient clinic at Maitama District Hospital Abuja's. A multistage sampling technique was used in this study. The data was analyzed using the IBM SPSS 28 (Statistical Package for the Social Sciences) computer software (IBM SPSS Inc. 2021). Ethical approval was granted by Bingham University Teaching Hospital, Jos, Plateau State. Results: The prevalence of antimicrobial use in the last 1 month, 6month and last 1 year was 41.5%, 32.0% and 5.6% respectively. A majority (74.25%) of the participants had gotten a prescription for the antibiotics from a doctor or nurse, 83.75% of them had received advice from a doctor, nurse or pharmacist on how to take the antibiotics while 16.25% of them had not. The antibiotics were sourced pharmacy (70.25%), hospital (22.5%), clinic (4.25%) while 3% stated other sources. Respondents stated that the conditions that can be treated with antibiotics, bladder infection or urinary tract infection (UTI) (75.2%), followed by Skin or wound infection (70.8%), Sore throat (62.4%) and Gonorrhea (55.9%) were the most selected. While other conditions were Cold and flu (48.5%), Fever (33.7%), Malaria (34.2%), Measles (30.7%), Body aches (21.3%), Headaches (11.9%) and HIV/AIDS (11.4%). Two thirds (63.25%) of respondents had good knowledge of antimicrobial use, 17.25% fair knowledge of antimicrobial use, and 19.5% poor knowledge of antimicrobial use. Test of association showed statistical significance for Age (χ² (2, N=400) = 69.56, p &lt; 0.003), Marital status (χ² (2, N=400) = 96.64, p &lt; 0.001) and Education (χ² (2, N=400) = 106.53, p &lt; 0.01). Conclusion: The prevalence of antimicrobial use in the last 1 month was 41.5%, prevalence in last 6 months was 32.0% and in last 1 year was 5.6% respectively.Two thirds of respondents had good knowledge of antimicrobial use, 17.25% fair knowledge of antimicrobial use, and 19.5% poor knowledge of antimicrobial use. Individuals and communities should develop proper health-seeking behavior, such as consulting a physician or a licensed health workers before using antimicrobials.

Knowledge of Antimicrobial Drugs among Outpatients in a Specialist Hospital in Abuja, Federal Capital Territory, Nigeria.

Background: Globally antimicrobials are a key tool in our fight against infectious diseases. Antimicrobial knowledge entails being familiar with the many classes of antimicrobials available and the infections they can treat. Assessing the knowledge of Antimicrobial is necessary among patients&nbsp; to avoid its misuse and development of antimicrobial resistance. It will aid in decision making and improving health seeking behaviour of patients.&nbsp; This study seeks to assess the knowledge of antimicrobial drugs among patients in a specialist hospital in Abuja Muncipal Area council, FCT, Abuja. Methods: This was descriptive, cross-sectional study done in September, 2022&nbsp; among clients attending outpatient clinic at a District Hospital Abuja's. it involved a sample size of &nbsp;sample size 423 with 400 responding .&nbsp; A multistage sampling technique was adopted for this study. The data was analyzed using the IBM SPSS 28 (Statistical Package for the Social Sciences) computer software (IBM SPSS Inc. 2021). The data was summarized using descriptive statistics which include the percentages, frequencies. Test of association was done using , the chi-square test (χ 2), and &nbsp;p-value less than 0.05 was considered statistically significant. Ethical approval was granted by Bingham University Teaching Hospital, Jos, Plateau State Results: One hundred and fifty respondents (37.5%) had good knowledge of antimicrobials, 141 (35.25%) had fair knowledge of antimicrobials, and 109 (27.25%) had poor knowledge (gave unsatisfactory answers to questions regarding knowledge about antimicrobials). Between male and female respondents. 22% of female respondents had good knowledge, 18.25% had fair knowledge &nbsp;and 16.75% had poor knowledge. Of all the male respondents, 15.5% had good knowledge, 17% had fair knowledge and 10.5% had poor knowledge. There was a statistically significant association between knowledge of antimicrobials with Marital Status (χ² (2, N=400) = 54.92, p &lt; 0.001)where more singles had poor knowledge of antimicrobial than married people, Education (χ² (2, N=400) = 87.16, p &lt; 0.001), where more of those with tertiary education had good knowledge of antimicrobials than those with no education or only primary education. &nbsp;and Age (χ² (2, N=400) = 56.84, p &lt; 0.001) as more younger people (18 - 29 years ) had good knowledge of antimicrobials than older people (40- 59 years).Conclusion: Over a third of clients had good knowledge of antimicrobials, a third also had fair knowledge while about a&nbsp; quarter had poor knowledge. The government and health care workers should support efforts towards improving the knowledge of communities on the basics of antimicrobials, in order to guide its use and improve antimicrobial stewardship.